Hives (Urticaria)
Hives are raised, itchy welts from histamine release. Acute hives resolve within six weeks; chronic urticaria persists beyond that and often has no identifiable trigger.
Symptoms
Pink or red itchy welts that vary in size and migrate -- individual lesions last less than 24 hours. Angioedema (deeper swelling of lips, eyelids, or throat) may accompany hives.
Causes and risk
Acute triggers include infections, medications, foods, or insect stings. Chronic urticaria is often autoimmune. Physical triggers include pressure, cold, heat, and exercise.
How it is evaluated
Acute hives rarely need workup. For chronic urticaria we check CBC, CRP, thyroid function, and autoimmune markers. Allergy testing is pursued when a trigger is suspected.
Treatment
Second-generation antihistamines at standard or higher doses are first-line. Omalizumab is FDA-approved for chronic urticaria unresponsive to antihistamines. Our Chicago team builds a stepwise plan.